Capture threshold and lead condition analysis

Abstract

An exemplary method includes performing a capture threshold assessment using a bipolar electrode configuration, deciding if capture occurred for a maximum energy value of the capture threshold assessment and, if capture did not occur, then performing a lead impedance test for the lead associated with the bipolar electrode configuration. Such a test may aim to detect an insulation defect and/or a conductor defect. Other exemplary methods, devices, systems, etc., are also disclosed.

What is claimed is: 
     
       1. A method to detect an insulation and/or a conductor defect in a lead, said method comprising:
 delivering a cardiac stimulus at a predetermined energy value using a unipolar electrode configuration, wherein the predetermined energy value corresponds to a predetermined capture threshold that has in the past produced a depolarization signal having an amplitude sufficient to register as an evoked response; 
 implementing evoked response detection using a bipolar electrode configuration; 
 if an evoked response did not occur per the detection, then delivering another cardiac stimulus at a higher predetermined energy value using the unipolar electrode configuration and implementing evoked response detection using a unipolar electrode configuration; and 
 if an evoked response occurred per the detection using the unipolar electrode configuration, then calling for a test of the bipolar electrode configuration. 
 
     
     
       2. The method of  claim 1  wherein the test of the bipolar electrode configuration comprises an impedance test. 
     
     
       3. The method of  claim 1  further comprising calling for a capture threshold test if the evoked response detection using the unipolar electrode configuration indicates that an evoked response occurred. 
     
     
       4. The method of  claim 1  further comprising testing the bipolar electrode configuration. 
     
     
       5. The method of  claim 4  further comprising reporting results of the testing. 
     
     
       6. The method of  claim 1  wherein the test provides results that comprise at least one member selected from a group consisting of insulation results and conductor results. 
     
     
       7. The method of  claim 1  wherein the higher energy value comprises a value associated with a back-up stimulus.